P-wave Dispersion Research Articles

Assessment of atrial conduction time and P-wave dispersion in patients with gestational diabetes mellitus

Assessment of atrial conduction time and P-wave dispersion in patients with gestational diabetes mellitus

Systemic Immune-Inflammation Index: A Novel Predictor for Risk of Postoperative Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Grafting.

To investigate the utility of systemic immune-inflammation index (SII) and inflammatory panel in predicting the risk of postoperative atrial fibrillation (PoAF) among patients undergoing elective isolated coronary artery bypass grafting (CABG). A total of 116 patients (mean age: 61.9 ± 9.8 years, 78.4% were males) undergoing isolated CABG were included in this retrospective study. Patients were divided into two groups, including those who developed PoAF (N = 26) and those without PoAF (N = 90). Inflammatory panel was evaluated in both groups. Patients with PoAF had significantly higher values for P-wave dispersion (PWD; 53.9 ± 5.9 versus 40.2 ± 5.1, P < .001), HATCH score (2.4 ± 1.3 versus 1 ± 1.1, P < .001), and left atrial dimension (4.0 ± 0.3 versus 3.8 ± 0.2 cm, P = .003). In the multivariate analysis with inclusion of PWD, HATCH score and SII, only SII (OR 1.007, 95% CI 1.002 to 1.012, P = .003) and PWD (OR 1.86, 95% CI 1.225 to 2.757, P = .002) were shown to be independent predictors of increased risk for PoAF. Preoperative SII seems to be a non-invasive readily available marker that significantly predicts the risk of PoAF in patients undergoing isolated CABG.

Can we explore AF–pacemakers’ relationship using clinical and echocardiographic parameters in patients with permanent pacemaker? (Echocardiography and subclinical AF in permanent pacemaker)

Patients on implanted permanent pacemakers frequently develop atrial fibrillation (AF). We aimed to determine the Echocardiographic and clinical parameters predicting AF in patients with a dual-chamber (DDD) pacemaker. This retrospective study included 208 patients with permanent pacemaker, classified according to development of AF during follow up into 2 groups: AF (77, 37%) and non AF (131, 63%), baseline: clinical, ECG(P-wave dispersion) and echo {diastolic wall strain (DWS),left arial volume index (LAVI), left ventricular stiffness index(LVSI)} data were assessed. AF group were older with more P wave dispersion, lesser DWS, greater LVSI& LAVI, LVSI at a cut off > 0.13 and DWS at a cut off < 0.34 were predictors of AF in patients with DDD pacemakers. LVSI and DWS could be used as simple good predictors for AF in patients with DDD pacemakers, for timely initiation of anticoagulants according to CHA2DS2VASc score to decrease ischemic stroke burden.

Preoperative P-wave parameters and risk of atrial fibrillation after cardiac surgery: a meta-analysis of 20201 patients.

OBJECTIVESTo evaluate the role of P-wave parameters, as defined on preprocedural electrocardiography (ECG), in predicting atrial fibrillation after cardiac surgery [postoperative atrial fibrillation (POAF)].METHODSPubMed, Cochrane library and Embase were searched for studies reporting on P-wave parameters and risk of POAF. Meta-analysis of P-wave parameters reported by at least 5 different publications was performed. In case of receiver operator characteristics (ROC-curve) analysis in the original publications, an ROC meta-analysis was performed to summarize the sensitivity and specificity.RESULTSThirty-two publications, with a total of 20 201 patients, contributed to the meta-analysis. Increased P-wave duration, measured on conventional 12-lead ECG (22 studies, Cohen’s d = 0.4, 95% confidence interval: 0.3–0.5, P < 0.0001) and signal-averaged ECG (12 studies, Cohen’s d = 0.8, 95% confidence interval: 0.5–1.2, P < 0.0001), was a predictor of POAF independently from left atrial size. ROC meta-analysis for signal-averaged ECG P-wave duration showed an overall sensitivity of 72% (95% confidence interval: 65–78%) and specificity of 68% (95% confidence interval: 58–77%). Summary ROC curve had a moderate discriminative power with an area under the curve of 0.76. There was substantial heterogeneity in the meta-analyses for P-wave dispersion and PR-interval.CONCLUSIONSThis meta-analysis shows that increased P-wave duration, measured on conventional 12-lead ECG and signal-averaged ECG, predicted POAF in patients undergoing cardiac surgery.

Evaluation of ECG Repolarization Parameters in a Worker Cohort Working the Night Shift.

ObjectivesNight Shift work is an increasingly common working order that affects human well-being and it is little known about its arrhythmic role in the cardiovascular system. We aimed to investigate the effect of working at night shifts on P-wave dispersion (Pd), QT and QTc dispersions (QTd, QTcd resp) on surface electrocardiography.MethodsWe included 286 foundry workers who work at night shift and 100 foundry workers who work on day time only. The night shift workers were divided into three subgroups according to the length of time they worked at night shift. Surface electrocardiography and blood tests were applied for all participants.ResultsPd, QTd and QTcd values increased in the night shift workers compared to the day time workers (p < 0.05). In subgroup analysis; the night shift workers for more than 15 years had a significantly higher Pd, QTd and QTcd compared to others (p < 0.001). Correlation analysis revealed significant positive correlations with working duration and Pd (r = 0.578, p < 0.001) and QTcd (r = 0.417, p < 0.001). In the linear regression analysis, working duration at night shift was significantly associated with Pd and QTcd values, independent from other associated clinical risk parameters.ConclusionsThis study makes one of the first attempts to assess changes in ECG parameters reflecting tendency to rhythm disturbances, in night shift workers. Our results further underline the importance of covering a comprehensive evaluation of ECG in periodical health check-ups in night shift workers to evaluate the risk of both atrial and ventricular arrhythmias.

Redistribution of adipose tissue is associated with left atrial remodeling and dysfunction in patients with atrial fibrillation.

ObjectiveAdipose tissue is recognized as a crucial regulator of atrial fibrillation (AF). However, the effect of epicardial adipose tissue (EAT) on the pathophysiology of AF might be different from that of other adipose tissues. The purpose of this study was to explore the distribution features of different adipose tissues in AF patients and their relationships with left atrial (LA) remodeling and function.MethodsA total of 205 participants (including 112 AF and 93 non-AF patients) were recruited. Color doppler ultrasound was used to measure the thickness of subcutaneous, extraperitoneal, and intra-abdominal adipose tissue. Cardiac CT scan was performed to measure the mean thickness of EAT surrounding the whole heart (total-EAT) and specific regions, including left atrium (LA-EAT), left ventricle, right ventricle, interventricular groove, and atrioventricular groove. LA anatomical remodeling and function were measured by echocardiography, while electrical remodeling was evaluated by P-wave duration and dispersion using Electrocardiography (obtained after cardioversion or ablation in AF patients). Relationship between the thickness of different adipose tissues and LA remodeling and function was analyzed.ResultsThe thickness of subcutaneous, extraperitoneal, and intra-abdominal adipose tissue was similar between AF and non-AF patients, and had no or only weak association with LA remodeling and dysfunction. However, compared to non-AF participants, total-EAT thickness significantly increased in both paroxysmal and persistent AF patients (non-AF vs. paroxysmal AF vs. persistent AF: 6.31 ± 0.63 mm vs. 6.76 ± 0.79 mm vs. 7.01 ± 1.18 mm, P < 0.001), which was positively correlated with the LA size and P-wave duration and dispersion, and negatively correlated with LA ejection fraction and peak strain rate. More interestingly, EAT thickness in AF patients did not increase uniformly in different regions of the heart. Compared to EAT surrounding the other regions, LA-EAT was found to accumulate more greatly, and had a closer relationship to LA remodeling and dysfunction. Multivariate logistic regression analysis also showed that LA-EAT was significantly correlated with the presence of AF (OR = 4.781; 95% CI 2.589–8.831, P < 0.001).ConclusionRather than other adipose tissues, accumulation and redistribution of EAT, especially surrounding the LA, is associated with LA remodeling and dysfunction in AF patients.

The Relationship Between Electrocardiographic P Wave Parameters and Left Atrial Volume and Volume Indices in Patients with Hypertension

Introduction: This study was designed to evaluate the relationship between left atrial volume index, which is an important indicator of left ventricular diastolic dysfunction, and electrocardiographic parameters such as P wave duration, P wave dispersion (PWDISP), P wave terminal force (PWTF), and P wave peak time (PWPT) in hypertensive patients. Patients and Methods: A total of 58 patients with a diagnosis of hypertension between June 2017 and April 2018 were included in this retrospective study. Age-sex matched 58 healthy subjects constituted the control group. The patients without diastolic dysfunction and stage I diastolic dysfunction were included in the normal left atrial pressure (NLAP) group, while stage II and stage III diastolic dysfunction patients constituted the high left atrial pressure (HLAP) group. Results: The PWDmax, PWDISP, and PWPT which are calculated from the lead DII (PWPTDII) were found to be longer in the group of hypertensive patients (p&lt; 0.05, for all). Electrocardiographic parameters of PWDmax, PWDISP, PWTF, PWPTDII, and PWPTVI were found to be longer in patients with HLAP. Both PWPTVI (p= 0.008 r= 0.395) and PWPTDII (p&lt; 0.001 r= 0.456) were significantly correlated with left atrial volume index. Conclusion: In this study, the relationship between PWPT and diastolic dysfunction was revealed for the first time in the literature. In addition, the PWPT was found to be increased in patients with increased left atrial pressure (LAP). Our findings deserve attention because electrocardiography is an inexpensive and easily accessible diagnostic method that can be used to detect diastolic dysfunction in hypertensive patients.

Research progress on the predictive value of electrocardiographic indicators in the diagnosis and prognosis of children with vasovagal syncope.

Neurally mediated syncope (NMS) is a common type of syncope in children in clinical practice, among which vasovagal syncope (VVS) is the most frequent. In recent years, more and more studies have been carried out to assess the diagnosis and prognosis of VVS. The electrocardiographic indicators such as heart rate variability (HRV), QT dispersion (QTd), P-wave dispersion (Pd), ventricular late potentials (VLP), deceleration ability of heart rate (DC), etc., are easy to obtain and inexpensive. With the help of electrocardiographic indicators, the diagnostic procedure and individualized treatment strategies of pediatric VVS can be optimized. This article reviews the value of electrocardiographic indicators in the diagnosis and prognosis of children with VVS.

Atrial electromechanical delay is impaired in patients with COVID-19

Background: COVID-19 infection has the potential to affect the cardiovascular system. Intra/ interatrial electromechanical delay (EMD) demonstrated by P wave dispersion (PD) and tissue doppler echocardiography (TDE) is related to the development of atrial fibrillation. This study aimed to investigate atrial conduction time by PD and TDE in patients with COVID-19.&#x0D; Material and Method: A total of 143 participants were selected in the current study. The COVID-19 group included 90 subjects and the control group included 53 individuals. Two groups were compared with each other, in terms of electrocardiographic P wave measurements, and atrial electromechanical coupling (AEC) parameters by TDE.&#x0D; Results: Maximum P-wave duration (Pmax) and PD were significantly higher in COVID-19 patients compared to the control group (p

Prognostic value of P-wave morphology in general population.

To evaluate the prognostic significance of novel P-wave morphology descriptors in general population. Novel P-wave morphology variables were analyzed from orthogonal X-, Y-, Z-leads of the digitized electrocardiogram using a custom-made software in 6906 middle-aged subjects of the Mini-Finland Health Survey. A total of 3747 (54.3%) participants died during the follow-up period of 24.3 ± 10.4 years; 379 (5.5%) of the study population succumbed to sudden cardiac death (SCD), 928 (13.4%) to non-SCD (NSCD) and 2440 (35.3%) patients to non-cardiac death (NCD). In univariate comparisons, most of the studied P-wave morphology parameters had a significant association with all modes of death (P from <0.05 to <0.001). After relevant adjustments in the Cox multivariate hazards model, P-wave morphology dispersion (PMD) still tended to predict SCD [hazard ratio (HR): 1.006, 95% confidence interval (CI): 1.000-1.012, P = 0.05) but not NSCD (HR: 0.999, 95% CI: 0.995-1.003, P = 0.68) or NCD (HR: 0.999, 95% CI: 0.997-1.001, P = 0.44). The P-wave maximum amplitude in the lead Z (P-MaxAmp-Z) predicted SCD even after multivariate adjustments (HR: 1.010, 95% CI: 1.005-1.015, P = 0.0002) but also NSCD (HR: 1.005, 95% CI: 1.002-1.009, P = 0.0005) and NCD (HR: 1.002, 95% CI: 1.000-1.005, P = 0.03). Abnormalities of P-wave morphology are associated with the risk of all modes of death in general population. After relevant adjustments, PMD was still closely associated with the risk of SCD but not with NSCD or NCD. P-MaxAmp-Z predicted SCD even after adjustments, however, it also retained its association with NSCD and NCD.

Polycystic Ovary Syndrome Triggers Atrial Conduction Disorders: A Systematic Review and Meta-Analysis.

Background: Polycystic ovary syndrome (PCOS) is closely related to various adverse cardiovascular manifestations and increased cardiovascular risk. However, atrial fibrillation (AF) development and atrial conduction abnormalities have not been thoroughly studied in patients with PCOS. Methods: This meta-analysis (CRD42021261375) was conducted in accordance with the PRISMA guidelines. Our aim was to investigate associations between PCOS and disorders in atrial conduction parameters linked with an increased risk for AF occurrence. Results: Five cohort studies with aggregate data on 406 adult women (229 with PCOS and 177 age-matched without PCOS) were included in this analysis. Our results showed a significantly increased mean difference in P-wave maximum duration (+7.63 ± 7.07 msec; p < 0.01) and P-wave dispersion (+11.42 ± 5.22 msec; p = 0.03) of patients with PCOS compared to healthy women. The mean difference in P-wave minimum duration (−2.22 ± 2.68 msec; p = 0.11) did not reach the statistical threshold between the compared groups. Echocardiographic measurements of atrial electromechanical delay (AED) also indicated a statistically significant mean difference in favour of the PCOS group in all assessed parameters, except for atrial electromechanical coupling (PA) in the tricuspid annulus. Particularly, PCOS was associated with increased lateral PA, septal PA, inter- and intra-AED durations (mean difference: +17.31 ± 9.02 msec; p < 0.01, +11.63 ± 7.42 msec; p < 0.01, +15.31 ± 9.18 msec; p < 0.01, +9.31 ± 6.85 msec; p < 0.01, respectively). Conclusions: PCOS is strongly associated with alterations in several electrocardiographic and echocardiographic parameters indicating abnormal atrial conduction. Therefore, PCOS could be considered as a causal or triggering factor of AF. Larger studies are needed to confirm these results and investigate direct associations between PCOS and AF.

Biot-spherical squirt (BISSQ) model for wave attenuation and dispersion

SUMMARYIt has been widely recognized that seismic attenuation and dispersion can be induced by various mechanisms. Wave induced fluid flow (WIFF) is one of the popular mechanisms to interpret seismic wave attenuation and dispersion, especially at microscopic scale. In this study, we focus on the local flow induced by different compliances of adjacent pores and develop a unified model called BISSQ (Biot-spherical squirt) model based upon the Biot and spherical squirt flow theories. The proposed model is an extension of BISQ (Biot-squirt) model. The P-wave velocity and attenuation of BISSQ model are influenced by two mechanisms: the Biot and spherical squirt-flow mechanisms. To evaluate the impact of these two mechanisms on seismic wave propagation, we use different parameters (e.g. squirt flow length, fluid viscosity, permeability, saturation and so on) to simulate wave attenuation and dispersion. We then apply the proposed model to Fox Hills Sandstone, which shows that the model can realistically predict P-wave velocity dispersion. To sum up, our proposed model offers an alternative squirt flow attenuation mechanism, which can describe fluid state of squirt flow reasonably and help us to assess the effect of different parameters on seismic wave attenuation.

Patients with metabolic syndrome and premature atrial contractions: predicting the atrial fbrillation onset

Aim . To develop an algorithm for the prediction of the atrial fbrillation onset in patients with metabolic syndrome (MS) and premature atrial contractions (PACs) in a prospective study. Materials and Methods . We enrolled 1,726 MS patients (age range 45-75 years) with ≥ 100 PACs per day. We measured cardiac chamber volumes, left ventricle contractility, parameters of the atrial electrocardiogram, P-wave dispersion, and the origin of PACs, further calculating the potential index of atrial fbrillation (PI) according to the CHARGEAF (RCHARGE-AF) model. The follow-up was 1-5 years. Maintenance of sinus rhythm or development of atrial fbrillation (AF) were the study endpoints. Results . Paroxysmal or persistent AF was registered in 218 (12.41%) patients. Elderly patients with MS and RCHARGE-AF score ≥ 0.72 units or predictors of AF development of AF (e.g., PACs or atrial enlargement) belonged to AF risk group. Development of AF in patients with MS correlated (OR &gt; 3) with left atrial end-diastolic volume index &gt; 34 mL/m2 with its average increase of +5% per year (OR = 3.3), RCHARGE-AF ≥ 0.72 (OR = 4.2), and PI &lt; 8 units followed by an average regression of -20%/ year (OR = 14.8). The accuracy of predicting atrial fbrillation within 3-5 years before its onset was ≈ 60%, reaching ≥ 86% for the 3-year time frame. Conclusion . Our forecasting algorithm can identify the risk groups and predict the development of AF in patients with MS and PACs.

Increased P-wave dispersion in patients with obstructive sleep apnea syndrome: a meta-analysis.

Prolonged atrial conduction and inhomogeneous sinus impulse propagation may play a role in the initiation and maintenance of atrial tachyarrhythmias. Such a process could be reflected in inter-lead P-wave duration differences known as "P-wave dispersion" (PWD). Abnormal PWD may be related to obstructive sleep apnea syndrome (OSAS). A meta-analysis of the available publications was conducted. A MEDLINE, Web of Science, and Google Scholar search from 2000 to 2021 was performed. The keywords used for search were apnea AND "P wave dispersion." Case-control studies and surveys were selected as long as they included healthy subjects and subjects with diagnosed OSAS who did not have any other major health problems. PWD values and correlations between apnea-hypopnea indices (AHI) and PWD were used as outcome measures. Ten studies met the inclusion creteria, encompassing 773 patients with OSAS and 347 healthy controls. The mean ages of the patients withOSAS ranged from 6.9 to 58.8 years. The estimated average Hedges's g standardized mean difference in PWD values was equal to 1.883 (95% CI: 1.140 to 2.626, p < 0.001). The estimated average Fisher r-to-z transformed correlation coefficient between AHI and PWD was equal to 0.530 (95% CI: 0.075 to 0.985, p = 0.0225). Meta-regression analysis failed to find statistically significant correlations between the effect sizes and the mean age, male proportion, and the body mass index in the OSAS groups. OSAS is associated with increased PWD, which may predispose to atrial tachyarrythmias.

Electrocardiographic Markers of Arrhythmogenic Risk in Synthetic Cannabinoids Users.

Background: Synthetic cannabinoids (SCs) users appeared to have heightened risk for cardiac arrhythmias; however, current line of research is insufficient in terms of demonstrating both conventional and novel electrocardiographic arrhythmia risk indicators in this population. Objective(s): We aimed to investigate P-wave dispersion (Pwd), corrected QT interval (QTc), QTc dispersion (QTcd), Tpeak-Tend (Tp-e), Tp-e/QT ratio, corrected JT interval (JTc), and JTc dispersion (JTcd), which are shown among the risk factors for emergence of an arrhythmia, among SCs users, suggestive of possible adverse effects of SCs on the cardiac rhythm. Methods: Forty-one male SCs user patients who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) substance use disorder criteria and 41 healthy male controls included in the study. Substance-related characteristics were recorded. Electrocardiography recordings under standardized procedure of all participants were performed and arrhythmia risk markers were calculated from electrocardiograms (ECGs). Results: Age and heart rate per minute did not significantly differ between the groups. SCs user group had significantly higher Pwd, QTc, QTcd, Tp-e, Tp-e/QTc ratio, JTc, and JTcd values compared with controls. Among risk markers, only Pwd was significantly correlated with duration of SCs use. Conclusions: Alterations in ECG-derived markers of arrhythmia, which are acquired through an easy and cheap method, should be evaluated for the prediction and prevention of severe cardiac conditions in patients with SCs use.

Global cognitive function correlates with P-wave dispersion in frail hypertensive older adults.

P‐Wave Dispersion (PWD) is an ECG parameter defined as the difference between the longest and the shortest P‐Wave duration. PWD has been associated with hypertension, a leading cause of age‐related cognitive decline. Moreover, hypertension is associated with vascular dementia and Alzheimer's Disease. Based on these considerations, we evaluated PWD and global cognitive function in frail hypertensive older adults with a previous diagnosis of cognitive decline. We evaluated consecutive frail hypertensive patients ≥65‐year‐old with a Mini‐Mental State Examination (MMSE) score <26. Patients with evidence of secondary hypertension, history of stroke, myocardial infarction, or therapy with beta‐blockers or acetylcholinesterase inhibitors were excluded. Beta‐blocker therapy causes a significant decrease in PWD; patients treated with acetylcholinesterase inhibitors were not included to avoid confounding effects on cognitive function. By examining 180 patients, we found that PWD significantly correlated with MMSE score. Strikingly, these effects were confirmed in a linear multivariate analysis with a regression model. To our knowledge, this is the first study showing that PWD correlates with global cognitive function in frail hypertensive older adults.

Early Detection of Iron Overload Cardiomyopathy in Transfusion Dependent Thalassemia Patients in Sulaimaniyah City, Iraq.

BackgroundLifelong blood transfusion is recommended for patients with transfusion-dependent thalassemia (TDT) that lead to iron overload and results in cardiomyopathy (CM).AimTo assess the accuracy of several electrocardiographic (ECG) data in patients at high risk of arrhythmia, early detection of structural and functional changes in left atrium and ventricle using ECG and echocardiography (two dimensional, M-mode echocardiography along with Doppler studies), and to observe the correlations between plasma B-type atrial natriuretic peptide (BNP)/serum ferritin and ECG with Doppler as well as echocardiographic changes in patients with TDT.MethodsThe current prospective case-control study included 75 TDT patients and 74 control subjects with the mean age of 9.55 and 9.93 years, respectively. Participants were assessed for the socio-demographic, physical examinations, serum ferritin, plasma BNP, ECG, 2D echocardiography, and tissue/pulse wave Doppler.ResultsThe mean of serum ferritin and plasma BNP were significantly (p<0.001) higher in the cases (1475.19 ng/mL and 47.63 pg/mL, respectively) than controls (41.3 ng/mL and BNP 23.37 pg/mL, respectively). ECG findings showed significant higher P-wave dispersion, QRS duration, QT duration and dispersion, and JTc dispersion in cases than controls. Echocardiography findings revealed diastolic dysfunction with preserved ejection fraction (EF) in thalassemia cases, as well as significant higher left ventricular (LV) mass, LV internal diameters during systole and diastole (LVIDs and d) and LV posterior wall thickness during diastole (LVPWd) in cases than controls (p<0.05). Also, a significant (p<0.05) correlation between BNP and QT dispersion was found in patients.ConclusionThese findings suggest the usefulness of ECG, 2D echocardiographic, Doppler studies and plasma BNP, with no significant beneficial effect of serum ferritin level in detecting early cardiac changes in patients with TDT.

The relationship of benign prostatic hyperplasia's symptoms severity with the risk of developing atrial fibrillation.

BackgroundAttention is drawn to the increased incidence of atrial fibrillation (AF) in benign prostatic hyperplasia (BPH) patients recently. Early predicting of AF in these patients can help in decreasing its clinical consequences. The aim of our study is to determine the association between BPH symptoms and AF predictors atrial electromechanical delay (AEMD) and the P‐wave dispersion (PWD).Methods218 healthy individuals recently diagnosed with BPH were assigned into three groups according to symptoms severity using the International prostate symptom score (IPSS) questionnaire. The first group with mild symptoms (IPSS score between 0 and 7, n = 78), the second group with moderate symptoms (IPSS score between 8 and 19, n = 86), and the third group with severe symptoms (IPSS score between 20 and 35, n = 54). PWD and AEMD calculations were performed for all participants.ResultsThere were statistically significant differences between the three groups in terms of AEMD and PWD (p < .01 and p < .01, respectively). In all three study groups, a significant positive correlation was observed between IPSS questionnaire scores and both AEMD and PWD (for AEMD r = .29, p = .013 and for PWD r = .27, p = .017). On the other hand, there were significant differences between the three groups in terms of the inflammatory markers C‐reactive protein (CRP) and fibrinogen (p < .01 and p < .01, respectively) and in terms of serum testosterone levels (p < .01).ConclusionsWe concluded that periodic evaluation of patients with BPH in terms of symptoms severity can be helpful not only from urological aspect, but also in the early prediction of possible serious cardiovascular morbidity and mortality.

The Relationship Between P-Wave Dispersion, QTc Dispersion, and Gestational Hypertension

Abstract Background To analyze the relationship between gestational hypertension and P-wave dispersion and QTc interval dispersion. Methods From January 2017 to December 2019, 213 pregnant women who met the diagnosis of hypertension were selected as gestational hypertension with 248 healthy pregnant women as controls. The basic data, P-wave dispersion, and QTc dispersion were compared between the 2 groups, and binary logistic regression analysis was performed. Results The minimum time of P wave (78.59 ± 9.32 vs. 94.61 ± 7.03 ms) and the minimum time of QTc (384.65 ± 21.69 vs. 401.91 ± 15.49 ms) in gestational hypertension were significantly lower than those in the controls. The dispersion of P wave (42.75 ± 9.94 vs. 14.91 ± 4.03 ms), QTc (57.15 ± 16.10 vs. 21.42 ± 6.07 ms), the maximum time of P wave (121.34 ± 7.22 vs. 112.53 ± 6.43 ms), and the maximum time of QTc (441.80 ± 25.42 vs. 429.74 ± 27.83 ms) in gestational hypertension were significantly higher than those in the controls (all P &amp;lt; 0.05). Logistic regression analysis showed that P-wave dispersion (odds ratio = 1.795, 95% confidence interval 1.266–2.546), QTc minimum time (odds ratio = 0.905, 95% confidence interval 0.833–0.983), and QTc dispersion (odds ratio = 1.216, 95% confidence interval 1.042–1.420) were correlated with gestational hypertension. Conclusions P-wave dispersion and QTc dispersion are associated with gestational hypertension.

Electrocardiography Predictive Value on Coronary Slow Flow Phenomenon

Coronary Slow Flow Phenomenon (CSFP) is characterized by the slow flow of contrast in one or more epicardial coronary vessels without evidence of coronary artery stenosis during coronary angiography procedures. CSFP is fairly common at the time of elective angiography with an incidence of around 7% and accounts for about 4% of hospitalized unstable angina cases. Coronary angiography is currently still the only effective way to detect CSFP, but this procedure is an invasive procedure with high costs, there is a risk of allergy to contrast. Electrocardiography (ECG), as a widely available, inexpensive, and simple modality is felt to be an attractive alternative in early detection of this abnormality. The ECG parameters on CSFP discussed in this study include; p-wave dispersion, QT interval dispersion, QRS intrinsic (Tpeak-Tenddeflection duration), and QRS fragmentation. Further studies are needed on the ECG image in CSFP so that in the future ECG can be a cheaper and non-invasive diagnostic modality for CSFP compared to coronary angiography.